Root Canal Treatment: 6 Common Myths, and What Really Happens

By Dr. Mubasshir Fatmi

When I tell a patient they need a root canal, the reaction is almost always the same: worry. Root canal treatment has an unfair reputation, built on stories from decades ago. Today it is one of the most routine and successful treatments in dentistry, and in most cases it is the best way to save a tooth that would otherwise be lost.

What is a root canal, exactly?

Inside every tooth is a soft core called the pulp, which contains nerves and blood vessels. When deep decay, a crack or an injury lets bacteria reach the pulp, it becomes inflamed or infected. That is what causes the severe, throbbing toothache many people associate with root canals.

Root canal treatment removes the infected pulp, cleans and disinfects the inside of the tooth, and seals it. The treatment does not cause the pain; it relieves it.

Signs you may need one

• Pain that lingers after hot or cold food and drinks.
• Pain when biting or chewing, or a tooth that feels "high".
• Throbbing pain that wakes you at night.
• Swelling of the gum or face, or a small pimple on the gum that may ooze.
• A tooth that has darkened in colour after an injury.

Sometimes there are no symptoms at all, and the problem is found on a routine X-ray.

Myth 1: "Root canals are extremely painful"

With modern local anaesthesia and techniques, having a root canal feels very similar to having a large filling. Most patients are surprised at how comfortable it is. The pain people remember is usually the toothache before treatment, not the treatment itself.

Myth 2: "It's better to just pull the tooth out"

Nothing works quite as well as your own natural tooth. A missing tooth lets neighbouring teeth drift and tilt, affects your bite, and the bone underneath slowly shrinks. Replacing it properly with an implant or a bridge usually costs more, and takes longer, than saving it. Extraction is sometimes the right choice, but it should be a considered decision, not the default.

Myth 3: "A root canal can make you ill"

This idea comes from research done about a hundred years ago that has since been thoroughly disproved. There is no valid scientific evidence that root canal treated teeth cause disease elsewhere in the body. Leaving an infected tooth untreated, on the other hand, can allow infection to spread.

Myth 4: "It takes many painful visits"

Many root canals are completed in one or two appointments. More complex cases, such as teeth with curved roots or a severe infection, may need an extra visit so that medicine can be placed inside the tooth to settle the infection first.

Myth 5: "If the pain has stopped, I don't need treatment"

This is one of the most dangerous myths. When the nerve inside an infected tooth dies, the pain can disappear, but the infection does not. It can quietly spread into the bone and later flare up as a painful abscess. If you have been told you need a root canal, please don't wait for the pain to return.

Myth 6: "Once it's done, the tooth will last forever on its own"

After a root canal, a tooth can last a lifetime, but it needs protecting. Back teeth, which take the force of chewing, usually need a crown (cap) to stop them cracking. Skipping the crown is one of the most common reasons a root-treated tooth fails.

What happens during treatment

1. Numbing. The area is made completely numb with local anaesthetic.
2. Isolation. The tooth is kept clean and dry during the procedure.
3. Cleaning. A small opening is made in the tooth, and the infected pulp is removed. The root canals are then cleaned, shaped and disinfected.
4. Sealing. The canals are filled and sealed to stop bacteria getting back in.
5. Restoring. The tooth is closed with a filling and, where needed, a crown is fitted at a later visit.

After your root canal

• Mild soreness or tenderness for a few days is normal and usually settles with the painkillers we advise.
• Avoid chewing hard foods on that side until the final filling or crown is in place.
• Keep brushing and cleaning between your teeth as normal.
• Call us if you have swelling, severe pain or a reaction to any medicine.

The earlier an infected tooth is treated, the simpler the treatment and the better the outcome. If you have a toothache that lingers, don't wait for it to get worse.

If you have been told you need a root canal and you have questions, or you would like a second opinion, book a consultation. We will look at your X-rays together and explain every option, including the honest pros and cons of each.